原发性食管腺癌──附外科治疗27例报告

Primary esophagealadenocarcinoma ──Report of 27 Cases for Surgical Treatment

本文报告原发性食管腺癌２７例，占同期食管癌的１．１％（２７／２４５６）。２７例全部施行了手术切除，术后一、二、三、四年生存率分别为６６．７％（１８／２７）、３４．６％（９／２６）、１９．０（４／２１）和７．７％（１／１３），无五年生存者。疗效较食管鳞癌显著为未食管腺癌组织来源有三种：食管本身腺体、食管的异位胃粘膜、Ｂａｒｒｅｔｔ食管。组织学分四种类型：单纯性腺癌、腺鳞癌、表皮粘液样癌和囊性腺样癌，其中以单纯性腺癌和腺鳞病占绝大多数（２６／２７）。食管腺癌的诊断须有病理检查证实。早期手术是首选治疗方法。

Primary esophageal adenocarcinoma is rare. From Nov.1975 to Dec. 1991, 2456 cases carcinama of esophagus. were resected and 27 cases (1.1%,27/2456 ) with esophageal adenocarcinomawere histologically confirmed. Esophageal adenocarcinoma is of three origins:esophageal intrinsicgland,ectopic mucosa,and Barrett's esophagus. This adenocarcinoma may be subdivided into sim ple adenocarcinoma,adenosquamous carcinoma, mucoepdermoid carcinoma, and adenoid cystic carcinoma. Simple adenocarcinoma and adenosqumous carcinoma were most amount in four types above (26/27). Of all 27 cases follow-up: 1, 2, 3, 4-year survival rate was 66. 7% (18/27), 34.6 % (9/26), 19. 0% (4/21 ),and 7.7 % (1/13) respectively. No 5- year survival rate. The pregnosiswas more worse than that of the sequmous cell carcinoma of esophagus. The author consider earlyoperation would be held and cervical esophagogastrostomy after resected of all thoracic esophaguswould be adapted for patients diagnosised with esophageal adenocarcinoma.